Health care is the most important task of the public sector for the population. At the same time, government control that could lead to rationed medicine is very unpopular.
Emergency station in the Visp hospital.
A premium shock threatens in the fall, the likes of which Switzerland hasn’t seen for a long time. The forecasts for the premium for the coming year are between 5 and 10 percent. The pressure on the Federal Council and Parliament to implement cost-cutting measures is all the greater. Health Minister Alain Berset wants to introduce “cost targets” that hospitals and doctors should not exceed.
“Doctors, hospitals, health insurance companies, cantons and the federal government should come to an agreement and publicly announce in advance what cost growth they expect – and if it is higher, they should explain themselves,” said Berset in an interview with the NZZ. If the SP Federal Council has its way, it would be possible in the future to reduce the tariffs retrospectively. Parliament is expected to deal with such issues in the autumn session. The Medical Association FMH is alarmed: its President Yvonne Gilli speaks of “massive losses in medical care” and “state medicine”.
Premiums as a great burden
The doctors can reckon with a good chance of being successful with their opposition – at the latest in a referendum. This is indicated by the results of a new survey conducted by the Sotomo research institute on behalf of the Hirslanden private hospital group. It is true that 60 percent of Swiss people already say that health insurance premiums are difficult for them to afford. This share could increase with the bonus round in 2023.
And for most, the reason for the explosion in spending is also clear: unnecessary tests and treatments. At the same time, however, the respondents say that low health costs are the lowest priority for them. Much more important is high-quality healthcare for all, which is immediately accessible. Benefit cuts are unpopular. Accordingly, the doctors should be able to use their veto power by warning against rationing.
Especially since the population has the utmost trust in you and the hospitals. It is also the doctors who patients prefer to leave the decision to which hospital they should go to and whether treatment will be covered by basic insurance. On the other hand, the Federal Office of Public Health and the health insurance funds are distrustful – i.e. those actors who are particularly committed to cost containment.
Respondents consider health to be the state’s most important service, ahead of education, safety, environmental protection, transport and social welfare. Health reached this top position among supporters of all parties except the SVP and the GLP. But this belief in the state does not appear to mean that the population wants even more control of the health sector by politicians and authorities.
Better than in the rest of Europe
60 percent of the Swiss are satisfied with the local healthcare system, only 17 percent are dissatisfied. It also gets good marks in a comparison with other healthcare systems in Europe. The compulsory basic insurance introduced in 1996, which covers a very wide range of treatments, has a lot of support. Nobody wants a “two-class medicine” in which certain therapies are only available to low earners to a limited extent.
There are some notable differences between the language regions. The German-speaking Swiss are somewhat more in favor of forced competition among medical service providers than the French-speaking Swiss. The free choice of family doctor and hospital is much more important to them. At least on paper: the more expensive standard premium, which allows free choice of doctor, is no more widespread in western Switzerland than in the German-speaking cantons.
If the Swiss have to go to the hospital, three things are particularly important to them: treatment that is personally tailored to them, an appropriate number of nurses and access to the latest therapy options. Comfort is less important to them, such as a single room or good food. And only one in five attaches importance to being treated by the chief physician.